Research on sleep disturbances and CIO

I've been asked to provide a few research links on sleeping problems in elementary aged children. That's only fair and I'm happy to oblige.

Here are a few links that give some sobering details on the problems of sleep with children. The first link also gives a lot of suggestions on overcoming sleep issues. It mentions that 10% of children from kindergarten through fourth grade are so greatly sleep deprived that they fall asleep in school.

The second link is a summary on a research paper entitled "Sleep Habits and Sleep Disturbance in Elementary School-Aged Children." You can order the entire publication online, but the link below summarizes the findings into one comact paragraph. Basically they identified 15% of children with bedtime resistance and 37% of children having significant sleep problems in at least one sleep domain.

http://www.med.umich.edu/1libr/yourchild/sleepc.htm#ref1

http://www.ncbi.nlm.nih.gov/pubmed/10706346

For information on techniques on CIO, you can research "Ferber Method" or "modified Ferber method." Ferber is a pediatrician and the Director of the the Center for Pediatric Sleep Disorders at Children's Hospital in Boston. He knows a thing or two about sleep problems. A lot of people will refer to CIO as "Ferber method" or "Ferberizing." I don't know if that just makes them feel better or what. I call it what it is. He gives you tips for when you go back in to comfort them and how to increase the amount of time you let them cry. We found that with Reagan it actually makes things worse to go in and comfort her after a period so we just have to let her ride it out.

I should mention that Ferber does condone starting at around 4-6 months. I personally think that is way too early. At that age they still need food and they still need comforting. They are still developing a bond and trust with you. They need to know that if they cry you will be there to respond and it is impossible to spoil a baby at that age. They don't cry because they are trying to manipulate you, they cry because they need something.

If you still need reasons to believe that a lack of sleep can be a problem, read on. Sleep deprived children are sick more often, more likely to be overweight, don't grow as tall, have more trouble learning and remembering, and are more likely to injure themselves from a lack of coordination and increased clumsiness.

Whew! I think I need a nap now.

CIO Day 4

5 minutes to sleep!

I am hoping we finished our last day of CIO and our good little sleeper is back. Of course the million dollar question now is, what time will she wake up in the morning?

I just want to take the time to address the cry it out topic. Not because I feel the need to defend myself; it's more because I feel the need to educate. It is a debated method that some would never do and some take a little too far. I'm certainly not a CIO expert, but I have learned a thing or two about it and it is a method that works for us when necessary. Not all kids respond to CIO. For them, parents have to find other methods. If you tried CIO for several nights and you don't see a decrease in the amount of time they are crying, or they get too worked up (some to the point of gagging and throwing up), then I think another method would be more suitable.

I should also mention that I don't take CIO lightly. I don't believe in using it on babies at all. Reagan didn't sleep through the night until 10 months and that was ok with us. As long as she still needed to eat during the night I was going to feed her. We only started using CIO on a limited basis when Reagan had demonstrated that she had the ability and desire to sleep through the night and would have a relapse. I don't know what caused her relapse this last time, usually it happened after she had been sick. If she is sick and needs attention, we go to her. We don't let her cry. But a few nights of that and when she is well again she can still wake up out of habit to get the attention. Then we would use CIO.

CIO works best when you do it as soon as the problem arises. In this case, we let the problem go on for two weeks before we did CIO. Had we have done it sooner, she maybe would have only cried for two nights instead of four. It is hard to say. But the longer something has been a habit, clearly the longer it will take to establish a new routine.

Some say it is inhumane to let a child cry. I have a different perspective. I think it is inhumane that a child at the age of seven is invited to her first sleepover but can't go because she can't fall asleep without mom or dad lying in bed beside her. I think it is inhumane that a child at the age of six still can't sleep through the night without crying for his parents to come coax him back to sleep. Certainly those are extreme cases, but ones I know exist. You might think they'll outgrow it. The truth is most do, but enough don't. I think of those cases and think about how much sleep every member of the family has missed out on. Sleep is critical for development and mental wellbeing. If you and/or the kids aren't sleeping, you are missing out on health benefits. And then of course there is the social aspect that comes into play when a school age child still can't sleep through the night. I do realize that some of those kids have disabilities that prevent them from doing otherwise. But a vast majority of kids that age with sleeping issues just simply never learned how to sleep.

Reagan is old enough now that training her to have good sleep habits is an appropriate response. She has the ability and the aptitude to comprehend what is expected of her. Kids like routines. They thrive on routines. Training her to go to sleep at night after her nightime routine is not any different than teaching her to brush her teeth every day or to take her medicine in the morning. If I need CIO for a few nights in order to establish a routine that will last years, so be it. I consider this "the ounce of prevention over the pound of cure."

CIO Day 3

23 minutes to sleep

CIO Day 2

25 minutes to sleep

We are moving in the right direction.

Here's the start of the story if you are just tuning in.

Sleeping woes

Only a few weeks into blogging and I am already talking about the subject that strikes almost every family with a toddler at some point: sleeping (or lack thereof).

Reagan has been a good sleeper for a long time. We transitioned her to a toddler bed in October so that we could have the crib for Bailey when she arrived. Reagan did great with the toddler bed. For months and months, when it was time for bed she would willingly walk up the stairs, Bill would get her in her pjs, and she would walk over to her bed and climb in and say "ni-night." There was no crying, no tantrums, just good old "ni-night."

I don't know where or how we started to go wrong, but a few weeks ago she started resisting going to bed. She would hop back out of bed after us and start crying and would stand at her gate until you came. As soon as she saw you she would stop crying and go back to bed. But try to leave, and the crying and standing at the gate would start again. We have tried every known method and plenty of our own improvisations to get her to go to sleep. Even once we got her to sleep she would wake back up and we'd start all over again. Two nights ago it was over two hours and after 10pm before she was finally asleep for the night. Despite all of our efforts things were getting worse, not better.

So, as the last ditch effort last night we did the dreaded "Cry it Out" or "CIO." This isn't a method I don't believe any parent uses lightly. Unfortunately, it seemed like our last option. So, Bill put her to bed, walked out, and the crying at the gate began. And it continued. And continued. And continued. Part of the reason we don't do CIO is because Reagan is often as stubborn or more so than her parents. I will usually cave long before she is out of stamina. But not last night. We let her cry and 1 hr and 15 minutes later the crying stopped. This was half the time it took her to get to bed the night before but far more gut wrenching for us.

About 15 minutes later we went and checked on her. Had I not have been 99% postive I would have woken the slumbering beast, I would have taken a picture of what we found. It was the cutest, most pitiful thing I ever saw. When we walked up to her room at the gate, all you could see was two little feet. When you looked further, you could see that the poor baby had fallen asleep sitting up and leaning against her laundry hamper that happened to be right near the door. This is astounding because other than in her car seat, Reagan has never fallen asleep sleeping up or outside of a bed. Bill picked her up, put her in bed, she cuddled one of her babies, and stayed asleep until morning. She actually woke up in a good mood this morning. Something that is a bit of a rarity.

So all of that to say, I hope we are going to get back on track again. I'm hoping she/we don't suffer through another hour of CIO but I remind myself that it was till half the time of putting her down without it. Keep your fingers crossed that the sleeping fairy sprinkles her with plenty of magic dust tonight so she goes down without so much trouble. I want my good sleeper back!